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Chronic Prostatitis: When antibiotics and pain meds aren’t enough

Chronic Prostatitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Chronic Prostatitis: When antibiotics and pain meds aren’t enough

 

Dr. Eric Viegas, ND

 

Chronic Prostatitis is an inflammation of the prostate gland and commonly affects young males who have had a previous viral or bacterial infection. It is estimated that about half of all males will be diagnosed with some form of prostatitis during their lifetime. About 90% of these men fall into the category of chronic prostatitis (CP). CP can be caused by a history of sexually transmitted infections and E. Coli, but also occurs without the presence of bacteria or viruses. The most commonly reported symptom in CP is continuous or spasmodic pain that is described as “dull” or “aching”. Pain occurs either in the perineum, penis, scrotum, or low back. Urological issues like incomplete emptying of your bladder, obstructed flow, pain on urination & ejaculation, and sexual dysfunction add to what is usually an already high level of psychological stress.

 

Chronic nonbacterial prostatitis (CnbP), CP without the presence of an infection, is a multifactorial condition; psychological stress, lack of physical activity, food sensitivity, allergies, autoimmunity, and neuromuscular dysfunction are theories of possible triggers in the development of CnbP. After a thorough assessment to rule out other possible diseases, doctors will often prescribe antibiotic and pain relief therapy. Unfortunately, non-bacterial prostatitis has a tendency to recur after antibiotic therapy, and pain medications carry risks of gastrointestinal bleeding if used long-term.

 

Interstitial Cystitis (IC) shares symptom overlap with CPPS. People with IC develop pain, irritation, and urinary problems without the presence of an infection. Unfortunately, both IC and CPPS are treated with antibiotics for symptom relief, but antibiotics are not recommended as a primary therapy; nor should they be used if a person has failed to respond to antibiotics in the past. Men diagnosed with CP and CnbP may have IC; in which case, they fall into the category of Chronic Pelvic Pain Syndrome (CPPS).

 

Quercetin, a bioflavonoid I mentioned in my seasonal allergies post, is an excellent anti-inflammatory nutrient and mast cell inhibitor. Mast cells release histamine in your body, and have been found in high concentrations in the bladders of people with IC. A combination of quercetin, nettle root, pygeum, and curcumin may benefit people who suffer from IC and CP. A quality of life increase, and a decrease in symptoms of CP were reported by men with CPPS after a month long trial of Nettle, Pygeum, Curcumin, and Quercetin with antibiotics. Cernilton, a blend of rye pollens, has been used in the past to successfully treat urinary problems in men with benign prostatic hyperplasia (BPH); an enlargement of the prostate. BPH is similar to CP in that there is usually obstructive and inflammatory problems in the prostate and urinary ducts. Cernilton may benefit men who suffer from CPPS and CP by improving urinary symptoms, pain, and quality of life. A healthy inner bladder wall is lined by a protective substance known as glycosaminoglycans. The use of the glycosaminoglycans glucosamine, chondroitin, and sodium hyaluronate may help with symptoms of IC.

 

Men with CPPS do not have to suffer in silence. There are alternatives to commonly prescribed medications that can significantly improve urinary symptoms and quality of life. For more information on which nutrients and therapies are right for you, speak to your naturopathic doctor.

 

References:

  1. McGowan C., Krieger J. Prostatitis, Epididymitis, and Orchitis. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases 2015; Updated Edition 112: 1381-1387.
  2. Matsui, Hirofumi et al. “The Pathophysiology of Non-Steroidal Anti-Inflammatory Drug (NSAID)-Induced Mucosal Injuries in Stomach and Small Intestine.” Journal of Clinical Biochemistry and Nutrition 48.2 (2011): 107–111.
  3. Forrest JB, Schmidt S. Interstitial cystitis, chronic nonbacterial prostatitis and chronic pelvic pain syndrome in men: a common and frequently identical clinical entity. J Urol. 2004;172(6, pt 2):2561-2562.
  4. Katske F., Shoskes DA., Sender M., et al. Treatment of interstitial cystitis with a quercetin supplement. Tech Urol 2001; 7: 44-46.
  5. Cai T, Mazzoli S, Bechi A, Addonisio P, Mondaini N, Pagliai RC, Bartoletti R. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study. Int J Antimicrob Agents 2009; 33(6):549-53.
  6. MacDonald R1, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int. 2000; 85(7):836-41.
  7. Wagenlehner FM1, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009 Sep; 56(3): 544-551.
  8. Theoharides TC. Treatment approaches for painful bladder syndrome/interstitial cystitis. Drugs 2007; 67: 215-235.

Interstitial Cystitis: Some Ways to Relieve Urinary Pain and Anxiety

Interstitial Cystitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Interstitial Cystitis: Some Ways to Relieve Urinary Pain and Anxiety

 

Dr. Eric Viegas, ND

 

Interstitial Cystitis (IC) is an inflammatory condition of the urological system, particularly the bladder wall, and is thought to affect more women than men. Age of onset can be anywhere from childhood to middle-age, and a majority of people with IC are caucasian. As mentioned in my chronic prostatitis blogpost, men are often overlooked when it comes to IC, since most doctors assume it is a primarily female condition. Your doctor should perform a thorough work up to determine if your urinary condition is the result of prostate issues, IC, or other factors. Strangely, the urinary frequency, urgency, and pelvic pain common in IC often occur in the absence of any traceable infections or blood in the urine.

 

Pain flare ups of IC occur at the beginning of a woman’s period, and/or after sexual intercourse. People with IC may experience pain in the bladder, pelvis, vagina, tip of the penis, low back, and lower abdomen. IC can significantly compromise quality of life; people worry about getting to the bathroom on time and a normal everyday commute to work can be extremely panic-inducing. Psychological distress is a key factor in the worsening of anxiety and depression in people with IC.

 

There are two types of IC: classic or ulcerative IC, and non-ulcerative IC. In classic IC, the bladder develops patches of inflammation leading to ulcers and scarring. Overtime, classic IC causes reduction in bladder capacity. In non-ulcerative IC, there are no obvious physical changes to suggest pathology of the bladder wall. Unfortunately, little is currently known about how people develop non-ulcerative IC, and some people are mistakenly treated for chronic urinary tract infection (UTI) with antibiotics.

 

Some conditions associated with IC include irritable bowel syndrome, endometriosis, allergies, fibromyalgia and mood disorders.

 

Strenuous exercise, prolonged sitting, allergies, and certain foods can aggravate IC. Acidic foods like beer, tomatoes, chocolate, and coffee can aggravate symptoms of IC, so the first step in improving IC is to identify and eliminate these foods.

 

Some other foods that have been linked to a worsening of IC symptoms:

  • Lima beans, Lentils
  • Avocados
  • Peaches
  • Spicy Foods
  • Plums
  • Gluten
  • Grapefruit, Oranges, Lemons etc
  • Dairy
  • Pineapple
  • Raisins, Prunes

 

Demulcents are substances that can repair and soothe inflamed or irritated internal tissues. In IC, an irritated and inflamed bladder wall is the main culprit behind urinary frequency, urgency and pain. Your naturopathic doctor (ND) has access to a variety of botanical demulcents that can be combined in a daily drink to combat urological inflammation. Your ND can also add botanical medicines or nutritional supplements to combat anxiety and depression, to make your stress response more manageable, and improve your quality of life.

 

Quercetin–a bioflavonoid discussed at length in both my posts on allergies, and prostatitis—is a nutritional supplement that can stop the activation of mast cells in an allergic response and protect the bladder wall by reducing inflammation. The use of Vitamin A has been shown to inhibit mast cell activation, and protect mucosal surfaces from irritation and inflammation. Glucosamine, a member of the glycosaminoglycan family, can repair the bladder wall and allow for a more comfortable passing of urine.  

 

Naturopathic medicine offers a comprehensive treatment plan for IC. With dietary and lifestyle factors taken care of, NDs can use a variety of botanical medicines and nutritional supplements to decrease the severity of symptoms and improve quality of life for people with IC. There are many ways to find relief. Speak to your ND today!

 

References:

 

Espinosa G, Murray MT. Cystitis and interstitial cystitis/painful bladder syndrome. Textbook of Natural Medicine; 159: 1308-1317.

 

Ching C. Interstitial cystitis. First Consult 2012.

 

Abascal K, Yarnell E. Alternative and Complementary Therapies. April 2008, 14(2): 69-77. doi:10.1089/act.2008.14203.

 

Yarnell E. Alternative and Complementary Therapies. February 2009, 3(4): 269-275. doi:10.1089/act.1997.3.269.

 

Hudson T. Alternative and Complementary Therapies. July 2004, 7(2): 88-90. doi:10.1089/10762800151125074.

 

Hudson T. “Interstitial Cystitis: A New Approach.” Townsend Letter for Doctors and Patients, Feb. 2001, p. 172. Academic OneFile, Accessed 19 May 2017.

 

Dunlap C, et al. An integrative approach to interstitial cystitis. Explore: The Journal of Science and Healing 2013; (9)1: 48 – 52.